Determination of skeletal development by an X-ray of the left hand and wrist (Fig. 13.8) is a useful way of establishing the stage of the physiological development of a child, which may not be consonant with the chronological age. Thus, patients who are destined to undergo constitutionally delayed puberty will have a delayed bone age at a given chronological age, while others who enter puberty early may have an advanced bone age for chronological age.
